Safety Risks Tied to Electronic Health Records Need Scrutiny

Risks from expanded use of electronic health records remain largely unknown, justifying mandatory government reporting of patient deaths and safety problems linked to the technology, a U.S. panel said.

While health-care technology has reduced medical errors, data leaks and “poor human-computer interactions” may lead providers to deliver incorrect doses of medicine to patients or fail to detect life-threatening conditions, the Institute of Medicine said today in a report.

“Just as the potential benefits of health IT are great, so are the possible harms to patient safety if these technologies are not being properly designed and used,” said Gail L. Warden, president emeritus of Henry Ford Health System in Detroit and chairwoman of the institute committee that wrote the report.

The U.S. Department of Health and Human Services should develop a plan within 12 months to minimize risks and report annually on progress, the institute said. The Food and Drug Administration should begin regulating the new technologies if progress isn’t made within a year, the group recommended.

The federal government is spending $27.4 billion over six years to spur adoption of electronic health records by doctors and hospitals with the goal of improving patient safety. Because many vendors discourage a free exchange of safety information in contracts with providers, there is scant published evidence about problems and why they occur, the institute said in its report.

The Electronic Health Records Association in Chicago didn’t immediately respond to a request for comment. The trade group, part of the Healthcare Information and Management Systems Society, released a statement yesterday supporting efforts “to develop practical, effective, and optimized reporting tools to collect information on medical incidents that may be related to the use of health information technology.”

Case Studies

In its report, the institute cited instances in which two unnamed pediatric intensive care units in Pittsburgh and Seattle installed the same system. The Pittsburgh unit saw more patient deaths than the Seattle center, though both had the capability to electronically record, store, retrieve and modify orders such as prescriptions, according to the report.

“The differing impact on mortality rates may be due to the hospitals’ differences in the implementation and use of the CPOE system,” the institute said, referring to the technology.

The panel, part of the National Academy of Sciences, also urged Congress to create an independent federal entity modeled on the National Transportation Safety Board to investigate and analyze problems with health information technology and propose corrective steps.

The recommendations, which aren’t binding, were requested by the Department of Health and Human Services’ Office of the National Coordinator for Health Information Policy.

“More can and should be done to capture safety issues,” Farzad Mostashari, the department’s national coordinator for health information technology, said, agreeing with the institute’s conclusion.

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